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1 kg, respectively (Lee et al 1994). 4 kg weight loss after a 45-day programme involving 10 hours of exercise per day (Hadjiolova et al 1982). Unfortunately such findings are not the norm. A recent review of lifestyle intervention studies concluded that the average weight loss from combined diet and exercise programmes is 3 to 5 kg compared with no treatment or usual care. Moreover, in most studies with long-term follow-up, the initial weight loss is followed by weight regain (Jain 2005). How are these findings reconciled with the findings from studies demonstrating large exercise-induced weight losses?

There is also a need for a better indicator of the disease risks associated with obesity. The waist circumference is being used more frequently for such purposes and appears to be promising in this respect. Another need is for further research into the BMI and waist circumference cut-off points related to disease risk in ethnically diverse populations (Haslam & James 2005, Misra et al 2006). With regard to exercise, randomized controlled trials are required to clarify the role of physical inactivity for future weight gain.